Managing In-Home Sharps Disposal

Burbank, Calif.-February 2012 - Although it is illegal to throw used needles and syringes in the trash in California, more than 936 million home-generated sharps end up in the waste stream annually, according to CalRecycle. This is often due to the lack of convenient return options for users of these medical products.

Nationally, 13.5 million people use sharps outside the healthcare setting with up to 7.8 billion needles and syringes improperly disposed of each year, according to data from the U.S. Environmental Protection Agency. To find solutions to this problem, the California Product Stewardship Council (CPSC) recently co-hosted and facilitated a workshop at Providence Saint Joseph Medical Center in Burbank, Calif.

The workshop brought together retailers, manufacturers, recyclers, and waste management companies as well as academics, government representatives, and people from non-governmental organizations. Together, they looked at the problem and a range of possible solutions and opportunities in such areas as technology, partnerships, and sustainable design.

Part of the surge in used needles comes from the rising number of people with diabetes, accounting for 90 percent of the sharps generated, according to Tom Erickson, CEO of Ulti-Med, Inc. While 4 percent of users put used needles in a puncture-resistant container, 3 percent flush them down the toilet and 93 percent throw them in the trash. “Only 4 percent of sharps are disposed of in a puncture-resistant container and delivered to an approved medical collection site,” said Erickson. The only manufacturer that bundles containers with needles, Ulti-Med manufactures insulin syringes and pen needles in the U.S. and Canada.

As a result, an estimated 450,000 to 863,000 people outside of healthcare settings are injured by sharps each year, resulting in costs ranging from $1.7 to 3.7 billion per year nationally for associated injuries and infections, according to Janine Hamner, Community Relations Manager at Waste Management, Inc., referring to data from the Coalition for Safe Community Needle Disposal.

The three main infections from needle sticks-at least among health care workers-were from blood-borne pathogens such as hepatitis, HIV, and tetanus according to Nancy Parris, Director of Epidemiology and Infection Prevention at Providence St. Joseph Medical Center in Burbank.

Even if the risk of infection is low, the emotional and physical trauma to an individual stuck by a sharp, as well as the cost to his or her company can be very high. Production has to stop while hazardous material personnel are called in to handle it, “which can cost up to $3,000 per incident,” said Hamner.

Even though several states have legislation regarding sharps disposal-from banning disposal in trash which California and Maine have done to requiring hospitals and nursing homes to accept sharps in New York-most of the problem falls on local governments that are not equipped to handle it.

“Health and safety concerns drive home-generated sharps collection points to local government facilities,” said Tedd Ward, Del Norte Solid Waste Management Authority Program Manager. “Concerns about illegal disposal drive most public agencies to offer this costly service at no charge, requiring subsidies from some other source of revenue.”

Faced with a crisis, local governments are responding with innovative programs. In Los Angeles, the County Public Health Department created partnerships to designate 14 health clinics for distribution and collection of sharps waste. “Home-generated sharps waste is added to the clinics existing medical waste-stream disposal,” said Natalie Jiminez, Environmental Affairs Manager of the Department.

The agency also partnered with the L.A. County Sheriff’s Department to designate 21 sheriff stations for collection. “In FY 2010-2011, they collected approximately 9,000 pounds of sharps waste,” said Jiminez.

Santa Cruz County had a similar story: 21,388 lbs. of sharps collected during the 3-1/2 year period from the start of its collection program. Their program also included take-back sites for pharmaceuticals. “The cost of pickups for both was $73,740,” said Jeffrey Smedberg, Recycling Programs Coordinator at the Public Works Department in Santa Cruz.

Bill Worrell from the San Luis Obispo County Integrated Waste Management Authority had a similar story-1 million sharps collected at 47 locations.

Even though California passed a law requiring drug manufacturers to submit plans outlining what, if anything, they are doing to help consumers safely dispose of home-injected products, the outlook isn’t good. Tom Campbell from the California Sharps Coalition talked about the Coalition’s report card for the plans. Out of the 22 reporting companies, only two received an “A” -those being Abbott Laboratories and Johnson & Johnson. The vast majority, 15 in all, received an “F.”

Product stewardship can work. In the 1990s, nearly all pharmacies in Canada began offering free sharps containers and disposals to attract diabetic customers, an example of market-driven product stewardship.

CPSC’s Sanborn said there was a need for extended producer responsibility (EPR) that would take the burden off local governments and return it to manufacturers, distributors, and retailers. “Some stakeholder recommendations,” she said, “include establishing drop-off points, providing safe return containers as well as education at point-of-sale. But no matter which methods are employed, we need help from sharps manufacturers and others in the product chain to solve this problem.”

The California Product Stewardship Council educates the public and private sector on product stewardship and partners with businesses, jurisdictions, waste and recycling companies, manufacturers, among others, to promote sustainable practices. For additional information about Product Stewardship go to www.calpsc.org

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